Ovarian stimulation havoc

Controlled ovarian hyperstimulation (COH) has wreaked havoc in reproductive medicine. Both multiple pregnancies and ovarian hyperstimulation syndrome may damage patients and their offspring. Costs of both are enormous both financially as emotionally. COH in intra-uterine insemination is only indicated in unexplained and mild male subfertility. There is still a discrepancy between the recommendations of professional societies to avoid multiple pregnancies and daily practice. Not the crude pregnancy rate, but the birth of a healthy singleton baby should be the guideline in reproductive medicine. Physicians, policy makers and insurance companies should work together to reach this goal.